New Family Interview
Please complete this form to inquire about a space for your child(ren). Tonya or Betzy will get back to you as soon as possible. Thank you for your interest in HCCC!
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Email *
Your name: *
Physical + Mailing address(if different): *
Referred by OR how did you hear about us?  *
Best number to reach you at:  *
Email: *
Child(ren)'s name(s) and birthday(s):  *
Parents employment:  *
Do you need infant, toddler, or preschool care?  *
Do you need year round care or summer only?  *
Please indicate your scheduling needs (days of the week): *
What is your requested start date? *
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A copy of your responses will be emailed to the address you provided.
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